| NPI | 1891764437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 1288) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC001288) |
| 106H00000X Marriage & Family Therapist (Licence: SC 1011) | |
| 106H00000X Marriage & Family Therapist (Licence: GA MFT000648) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2007-07-08 |